I-18: The Ethics of Managing Extremely Premature Neonates(EPRN) between 22-24 Weeks

نویسنده

  • Hui E
چکیده مقاله:

When faced with a preterm delivery of an extremely premature neonate between 22-24 weeks (EPRN), doctors are confronted by a three-fold uncertainty of age, viability and prognosis that influence their decision whether or not to resuscitate the neonate. Firstly, in the delivery room the preterm neonate’s age is seldom precisely known, and successful resuscitation depends on the neonate’s accurate age; secondly, human fetal viability is uncertain and is determined by fetal lung development that takes place between week 22 to 25 of gestation as well as varying geographic contexts and institutional technical capabilities. Thirdly, EPRN presents with the uncertainty of long term morbidity. Outcome studies suggest that neonates on the high end of the “viability spectrum” have a survival rate about 40-50%, and for those who survive, about the same percentage will have moderate to severe long term morbidities including cerebral palsy, blindness, deafness, other neuro-sensory deficits, chronic lung diseases and mental and motor retardation. These uncertainties are translated into a three-fold dilemma of whether or not to treat the neonate, who should make the decisions and on what moral grounds are the decisions made. This paper attempts to address some of these questions.

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عنوان ژورنال

دوره 6  شماره 2

صفحات  -

تاریخ انتشار 2012-09-01

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